Affiliations: [a] Department of Biology, Faculty of Sciences, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran | [b] Biosciences and Biotechnology Research Center, Faculty of Advanced Technologies, University of Mohaghegh Ardabili, Namin 56318-51167, Iran | [c] Department of Biostatistics, Faculty of Public Health, Mazandaran University of Medical Sciences, Sari 48471-16548, Iran | [d] Gastrointestinal Cancer Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran | [e] Digestive Disease Research Center, Ardabil University of Medical Sciences, Ardabil 56189-53141, Iran
Correspondence:
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Corresponding author: Saeid Latifi-Navid, Department of Biology, Faculty of Sciences, University of Mohaghegh Ardabili, Ardabil 56199-11367, Iran. Tel./Fax: +98 45 33514701; E-mail: s_latifi@uma.ac.ir.
Abstract: BACKGROUND: Although the most extensive studies revealed the role of H. pylori VacA and CagA toxins in the development of gastric adenocarcinoma, the magnitude of this association and the correlations of vacA mosaicism and cagA status with cardia gastric adenocarcinoma (CGA) still remain controversial. OBJECTIVE: We aimed to examine the linkage of H. pylori highly cytotoxic genotypes to CGA in Iranian populations as a model. METHODS: A total of 601 Iranian patients were enrolled. Biopsies were cultured, genotyped, and anatomically and histologically classified. RESULTS: The vacA c1 genotype, but not cagA status, showed a strong association with the risk of both CGA and non-cardia adenocarcinoma (NCGA), whether the controls were non-tumors, as those with either non-atrophic gastritis or peptic ulcerations, (the OR (95%CI) was 14.11 (4.91–40.52) and 9.59 (4.06–22.65), respectively) or those with NAG (the OR (95%CI) was 10.71 (3.49–32.82) and 8.11 (3.26–20.16), respectively). The vacA c1/cagA+ genotype was significantly associated with an increased risk of NCGA, whether the controls were non-tumors or those with NAG; the adjusted risk was 4.706 (1.41–15.67) and 4.85 (1.42–16.51), respectively. CONCLUSIONS: The H. pylori vacA c1 genotype, but not cagA status, might be the first important bacterial biomarker for predicting the cardia adenocarcinoma risk in male patients aged ⩾ 55 in Iran.
